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Absenteeism of teachers and medical personnel is widely cited as a barrier to improvement of education and health outcomes in developing countries, especially in South Asia. But how severe is the problem of absent teachers–and in health care, absent medical personnel? This research project sets out to answer that question definitively in six countries: Bangladesh, Ecuador, India, Indonesia, Peru, and Uganda.

Survey teams made unannounced visits to random national samples of primary schools and health clinics and recorded whether they found teachers and health workers in the facilities. The report finds that, averaging across the six countries, about 19 percent of teachers and 35 percent of health workers were absent from their facilities. Providers were marked as “present” if they could be found anywhere in their schools and clinics, but some of these were not working.

Beyond the high overall absence rates, there are other indications that provider absence reflects systemwide problems. First, absence is typically fairly widespread: in most countries and states. Second, higher-ranking and more powerful providers, such as headmasters and doctors, are absent more often than lower-ranking ones.
The report suggests the following reasons for the pattern:

• Teacher absence is more correlated with daily incentives to attend work: teachers are less likely to be absent at schools that have been inspected recently, that have better infrastructure, and that are closer to a paved road.

• In the Indian case, we find little evidencethat attempting to strengthen local community ties will reduceabsence. Teachers from the local area have similar absence rates as teachers from outside the community.

• By contrast, there is some suggestion that rural private schools could help to raise low educational standards.Private-school teachers are only slightly less likely to be absent than public-school teachers in general, but are 8 percentage points less likely to be absent than public-school teachers.

The report argues that conceptually, there seem to be three broad strategies for moving forward. One approach would be to increase local control, for example by giving local institutions like school committees new powers to hire and fire teachers. The second approach would be to improve the existing civil service system. The analysis suggests a range of possible interventions that might be worth testing. Some, such as upgrading school and clinic infrastructure, would involve extra budget outlays. Others, such as increasing the frequency and bite of inspections, could be implemented using existing rules already on the books.

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